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Melissa M. Cable; Intraocular Pressure Response in Glaucoma Patients Using Difluprednate 0.5% Post Operatively after Phacoemulsification. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6697.
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© ARVO (1962-2015); The Authors (2016-present)
To report rates of intraocular pressure spikes in open angle glaucoma patients undergoing uncomplicated phacoemulsification surgery using difluprednate ophthalmic emulsion 0.05% qd postoperatively.
Retrospective chart review using electronic health records was used for 24 patients who had a diagnosis of open angle glaucoma but were not known steroid responders and who were currently using pressure lowering medications, had undergone slt or both.
Avg preop IOP was 19.3 mm Hg. 17/24 patients were currently on prostaglandin, 5 on combination drop, 9 had undergone slt. 2 patients were on 2 IOP lowering meds, another 2 were on 3 medications. Avg IOP on POD1 was 22.5. 16.5% of patients had an iop spike of >10mm Hg (avg 17 mm Hg) and 37.5% had a spike of >5 mm Hg. 7 patients were treated with drops, 5 only discontinued durezol, 4 had no change to regimen. All IOPs were normal at week 6 with average IOP 13 mm Hg.
Glaucoma patients even without a history of steroid response are more likely to develop IOP spikes after surgery and with any steroid use. Difluprednate is a strong steroid and may cause early and significant elevations of IOP after uneventful cataract surgery. Caution should be used with postoperative difluprednate in patients with a known history of glaucoma.
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